Toward a new philosophy of preventive nutrition: from a reductionist to a holistic paradigm to improve nutritional recommendations

Abstract

The reductionist approach has been predominant to date in human nutrition research and has unraveled some of the fundamental mechanisms at the basis of food nutrients (e.g., those that involve deficiency diseases). In Western countries, along with progress in medicine and pharmacology, the reductionist approach helped to increase life expectancy. However, despite 40 y of research in nutrition, epidemics of obesity and diabetes are growing each year worldwide, both in developed and developing countries, leading to a decrease in healthy life years. Yet, interactions between nutrition-health relations cannot be modeled on the basis of a linear cause-effect relation between 1 food compound and 1 physiologic effect but rather from multicausal nonlinear relations. In other words, explaining the whole from the specific by a bottom-up reductionist approach has its limits. A top-down approach becomes necessary to investigate complex issues through a holistic view before addressing any specific question to explain the whole. However, it appears that both approaches are necessary and mutually reinforcing. In this review, Eastern and Western research perspectives are first presented, laying out bases for what could be the consequences of applying a reductionist versus holistic approach to research in nutrition vis-à-vis public health, environmental sustainability, breeding, biodiversity, food science and processing, and physiology for improving nutritional recommendations. Therefore, research that replaces reductionism with a more holistic approach will reveal global and efficient solutions to the problems encountered from the field to the plate. Preventive human nutrition can no longer be considered as "pharmacology" or foods as "drugs."

FIGURE 1

Life expectancy and healthy life years in France.

FIGURE 2

The top-down (holistic) compared with bottom-up (reductionist) approaches to research.

FIGURE 3

The different levels of observation in human nutrition research (see also reference 16). TV, television.

FIGURE 4

LD analysis scores of urine ¹H-NMR spectra highlighting the differences before, during, and after a dietary change (days 14–15) and between urine sampling times (PP and PA). Dashed lines, RF followed by WGF consumption (RF-WGF) group; solid lines, WGF followed by RF consumption (WGF-RF) group. Each polygon represents the limits of the metabolic profile (i.e., the whole set of metabolites) obtained for the 10 rats in a given group on a given day and urine sampling time. Urine samples were collected from days 13 to 28 (as shown within the figure). Reproduced from reference with permission. LD, linear discriminant; PA, postabsorptive; PP, postprandial; RF, refined flour; WGF, whole-grain flour.

FIGURE 5

From a reductionist pharmacologic approach to an integrative holistic approach to preventive nutrition to meet global recommendations. Reproduced from reference with permission.